XP: Q about IVF & placental abruption risk - induce early?

BlueEyedDreamer · January 2014

Hi SAIF! I hope to be joining you here in a few short weeks.

I have a question that I wanted to XP since some of you may know more about it than my fellow PAIFers.

My doctor said to me at our u/s yesterday to get ready to talk about labor and delivery at my cervix check next week. He also mentioned that IVF pregnancies have a higher chance of placental abruption, which can lead to stillbirth without any warning, and that it may be a good idea to consider inducing ~1wk prior to my EDD to minimize this risk.

Does anyone know anything about this? I felt a little bit blindsided by this info since I hadn't heard about it before. I was hoping to avoid inducement, but I really trust my doctor, too. I'm working on doing some independent research on this but thought I'd come here to find out if any of you have heard of this. Thanks, ladies!

Mrs.AmyDylan · January 2014

So I didn't deal with this since I was at a birthing center and J came at 38w. However, my IRL IVF buddy fended off her OB practice until 42w. Her son is fine. I think this might be due to many IVF mom having risk factors associated with placental abruption (35+ is a big one).

Every time they tried to take the baby, she would ask what risk factors she was exhibiting that worried them. When they couldn't give her one she said they would discuss at her next appointment.

Research and get informed. I think many OBs would rather ere in the side of caution, especially with IVF patients.

itsmevkb · January 2014

How old are you? I've only had one pregnancy from and IVF and my doctor never discussed this being a possible concern, however, he had other concerns and we both knew I'd never make it past 38 weeks so even if it was a concern of his it may not have come up for that reason.

If I were age 40 or over, IVF or not, I would not let myself go past my due date. I know many, many women do and it all works out but just for me, I wouldn't.

PurpleIris30 · January 2014

This was not raised by my OB or MFM. I guess I'd ask a lot of questions. Inductions have risk factors, too, so I'd want to compare the risks of each approach, rates of incidence, if i had other risk factors, and severity of the risks before making a decision.

CarrieB. · January 2014

I had an IVF and a FET pregnancy and with the first my water broke at 40w1d and I needed pitocin to start labor and with my second I was induced at 40w4d because I couldn't stand being pregnant any longer. She was a really big baby and got stuck on the way out, so I'm glad I was induced.

But anyway, IVF alone shouldn't make you high risk for anything and I would seriously side eye any OB who wants to induce early. If you are IVF plus other risk factors, then see an MFM for another opinion.

PennyLane26 · January 2014

Ditto @CarrieB. - I was induced for pre-e and know it was the right decision. I would push for more of an explanation if your OB wants to induce. Inductions are sometimes necessary, but pitocin is no joke! I wouldn't want it if it wasn't necessary. I've never heard of this.

CallMeAl · January 2014

I think the other ladies have it covered. I would ask a lot of follow up questions before agreeing to a 39 wk induction due solely to IVF. It wasn't something my OB (who is also a licensed MFM) ever brought up and induction significantly increases the chances of needing a c-section. Good luck with your decision!

mcgeeva · January 2014

I have never heard of that being the reason why it happened. I had a partial placenta abruption my last pregnancy at 31 weeks and went into labor. But it could of been due to high bp not being diagnosed etc. And I just did stims with IUI. But a few weeks later had full blow pre-e that was toxic by the time they realized. But with placenta abruptions when it happens you know. I was pouring blood everywhere. So I feel like maybe they are warning you without cause unless they somehow saw an issue with your placenta already? As far along as your are I wouldn't worry about it. Don't let them push you around for things that are not necessary.

BlueEyedDreamer · January 2014

Thanks, everyone! I will definitely do some further research and ask a lot of follow up questions. It's just something he mentioned to consider at the end of my appointment, and he did mention that it had actually happened to a couple of his patients during his career. He also said he would not induce if he wasn't certain that a vaginal birth was the likely outcome. I'm really hoping to avoid induction, so hopefully I can get some answers at my next appointment to help me make a good decision.

Thanks again, and I hope to be here with you all soon!

STL34 · January 2014

I have one daughter from IVF and I was induced at 39 weeks and 1 day. But, my induction was because I was on Lovenox for blood clotting issues and not because I was pregnant from IVF. When you are on blood thinners, they prefer to induce you so that they can time when to stop the blood thinners.

4legsRbest · January 2014

Here is my personal experience. I went to almost 42 weeks with H and had to be induced becuase he wasn't budging ad my midwifecould no longer care for me (and I was 35 at the time). I went natural with pitocin (BAD idea) and had an acute placental abruption at 7cm. It was the most terrifying thing I have ever experienced, but my child is alive, and that is all that matters. I don't know if it was related to the IVF, if the pitocin caused it, the fact that he was in there so long and the placenta was getting old, that I am 35, or if it was just a fluke. My abruption happened during labor so it isn't the same thing as what your dr is talking about but I read a ton about this after it happened and I would be ery wary of induction. The guy who ended up being my dr (midwife couldn't help at that point) believes that it was the pitocin. The contractions are so intense, the placenta has been known to detach from the sheer force of them. Good thing is that you would be monitored, as well as your baby (with a probe). And ditto what PP said, when you abrupt, you know. I was hemmoraging blood so bad even my mom knew what was happening.

This is one of those damned if you do, damned if you don't things becuase you will nervous either way now that he put it in your head, but from my own research, I don't think there is enoguh evidence to support IVF being the culprit, but there is a ton of support for pitocin being a culprit. I would not induce at 39 weeks for this reason. Just my opinion!

Good luck!!

BlueEyedDreamer · January 2014

4legsRbest said:

Here is my personal experience. I went to almost 42 weeks with H and had to be induced becuase he wasn't budging ad my midwifecould no longer care for me (and I was 35 at the time). I went natural with pitocin (BAD idea) and had an acute placental abruption at 7cm. It was the most terrifying thing I have ever experienced, but my child is alive, and that is all that matters. I don't know if it was related to the IVF, if the pitocin caused it, the fact that he was in there so long and the placenta was getting old, that I am 35, or if it was just a fluke. My abruption happened during labor so it isn't the same thing as what your dr is talking about but I read a ton about this after it happened and I would be ery wary of induction. The guy who ended up being my dr (midwife couldn't help at that point) believes that it was the pitocin. The contractions are so intense, the placenta has been known to detach from the sheer force of them. Good thing is that you would be monitored, as well as your baby (with a probe). And ditto what PP said, when you abrupt, you know. I was hemmoraging blood so bad even my mom knew what was happening.

This is one of those damned if you do, damned if you don't things becuase you will nervous either way now that he put it in your head, but from my own research, I don't think there is enoguh evidence to support IVF being the culprit, but there is a ton of support for pitocin being a culprit. I would not induce at 39 weeks for this reason. Just my opinion!

Good luck!!

This was super helpful info. Thank you for sharing your story, and I'm glad that you and your LO are okay!

CarrieB. · January 2014

OP- I just also wanted to add that you may want to Google Bishop's score for more info on inductions. You want to have a good score before doing an induction or it's more likely to fail and you end up w a Csection.

With my induction at 40w4d, my score showed that I was favorable to induction and my OB already knew that I responded well to pitocin so it was easy to go ahead with it and I was really sick of being pregnant.

Good luck!

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